| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
G0490 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
Face-to-face home health nursing visit by a rural health clinic (rhc) or federally qualified health center (fqhc) in an area with a shortage of home health agencies; (services limited to rn or lpn only) |
| HCPCS Short Description |
Home visit rn, lpn by rhc/fq |
| HCPCS Pricing Indicator Code 1 |
13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion) |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Code |
C - Carrier judgment |
| HCPCS Berenson-Eggers Type Of Service Code |
M4A - Home visit |
| HCPCS Type Of Service Code 1 |
1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96 |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
4/1/2016 |
| HCPCS Action Effective Date |
4/1/2016 |
| HCPCS Action Code |
N - No maintenance for this code |